ORLANDO, Fla. — Switching to the iron-based phosphate binder sucroferric oxyhydroxide (SO) may help dialysis patients with secondary hyperparathyroidism (SHPT) lower serum phosphorus levels to within target range, according to new findings presented at the National Kidney Foundation Spring Clinical Meetings.
“In patients with persistent severe secondary hyperparathyroidism, serum phosphorus control may not be readily achievable, which may reflect increased phosphorus release from bone and not necessarily from dietary absorption,” primary study author Stuart M. Sprague, DO, of NorthShore University HealthSystem in Evanston, Illinois, told Renal & Urology News. “Data presented in our study demonstrate improvement in serum phosphate levels independent of prevailing parathyroid hormone concentration.”
Using 2014–2015 records from Fresenius Medical Care databases, the investigators compared serum phosphorus levels (P) in 305 patients with intact parathyroid hormone levels (iPTH) at or below 800 pg/mL and 87 patients with iPTH above 800 pg/mL who were switched to SO during routine clinical care. One year after starting SO, 41.1% of the lower iPTH group achieved P levels at or below 5.5 mg/dL, compared with 23.3% patients before SO therapy. Similarly, 21.8% of the high iPTH group attained the phosphorus target at one year, compared with 11.5% of patients at baseline.
Patients also needed to take fewer pills compared with their previous treatment. The lower iPTH group reduced their mean number of phosphate binder pills from 8.4 to 4.0–4.2 daily. Pill burden in the high iPTH group likewise was cut in half from 8.1 to 4.2 – 4.5 pills per day. All results were statistically significant.
The study was funded by Fresenius Medical Care, the makers of sucroferric oxyhydroxide (Velphoro). Several investigators are employees of the company.
Sprague S, Ficociello L, Parameswaran V, Mullon C, and Kossmann R. Phosphorus Control in Patients Prescribed Sucroferric Oxyhydroxide With and Without Baseline Elevated Parathyroid Hormone. Presented at: National Kidney Foundation Spring Clinical Meetings. April 18-22, 2017. Orlando. Poster 196.